The pain was off the charts. Surgery was a last resort that helped get her back into action.
A month before her 28th birthday, Angela Crews was carrying a heavy piece of equipment at the photography studio where she worked. When she twisted to keep from dropping it, pain shot through her lower back.
Angela had x-rays and began physical therapy, but her pain worsened over the next three years. After consulting several orthopedic physicians and a pain specialist, she was diagnosed with degenerative disc disease—a condition that is relatively rare in a young, slim and active person like Angela. She was treated with further physical therapy, therapeutic exercise, electric stimulation, medication, steroid injections, and spinal manipulation by an osteopathic physician. But the pain remained.
Angela consulted Dr. Michael Brown, M.D., a neurosurgeon affiliated with Colorado Springs Neurological Associates P.C.; x-rays and MRIs revealed that her condition had worsened. She had degenerating and bulging discs in her lower back, along with thickening of the facet joints between the vertebrae. She received more injections and tried acupuncture and yoga to relieve her continuing pain, but to no avail.“All of these things were like Band-Aids,” Angela says. “They eased the pain temporarily but didn’t take it away.”
In fact, Angela’s pain kept getting worse. She began having weakness in her right leg, numbness in her toes, and spasms of her back muscles.
In January 2006, Angela’s right leg and hip suddenly locked up while she was at work. She was unable to walk and had severe muscle spasms and pain in her back, hip, and leg. She was treated with pain and anti-spasm medications at an emergency clinic. Two months later, Angela had a long talk with Dr. Brown. Since all of the conservative measures had failed to help, Dr. Brown suggested that Angela look into surgery. In the meantime, they continued conservative treatment.
The spasms, “lock-up,” and pain recurred on March 26, 2006. “When my husband tried to get me down the stairs, I passed out,” Angela says. “I passed out again when they were about to discharge me from the ER.” Angela was admitted to Memorial Hospital and stayed overnight. “The pain was off the charts,” Angela says. “I’d never felt anything like that. It was very scary. I couldn’t walk or dress, and I was very worried about how I could live a normal life if I didn’t find some solution. “We knew it was time to consider surgery.”
Finally, a Solution
“Angela had a condition that maybe 20 years ago we might not even have considered treating surgically,” Dr. Brown says. “Over the last decade or so, the treatment for this type of thing has evolved, especially surgery. We really still feel surgery should be a last resort, but Angela had long-standing pain that had reached the point where it was interfering with her daily activities, and she had exhausted all the other measures.”
Dr. Brown performs an operation called posterior lumbar interbody fusion, which was one option he discussed with Angela and her husband. He also asked his colleague and friend Dr. Joel D. MacDonald, a neurosurgeon and Associate Professor at the University of Utah, to review Angela’s case. After discussing their options with Dr. Brown and doing a considerable amount of research on their own, Angela and her husband decided to consult with Dr. MacDonald. They flew to Salt Lake City on April 27.
After examining Angela and reviewing her radiologic studies, Dr. MacDonald concluded that an operation called anterior lumbar interbody fusion would be the best option. The two-part procedure would involve surgically cleaning out the disks and inserting a titanium implant filled with bone graft material, then placing metal screws and rods to stabilize her spine. Dr. MacDonald and a surgical team at the University of Utah Hospital performed the procedure on May 15, 2006.
Angela recovered quickly after the procedure, which lasted nearly six hours. She needed pain medication the first day but started walking on the second day. By the fourth day, she was walking around the hospital and outside. After she returned to Colorado Springs, she continued her recovery at home for a week. Other than some residual tiredness from the anesthesia, “I felt great,” Angela says.
Angela was able to increase her activity gradually over the next six months. She has lost some mobility in her back, cannot do heavy lifting and must stay away from high-impact sports such as running. But four years after her surgery, she is pain free. “I don’t feel at this point like I’m missing out on anything, because the things I love, I can do,” she says.